Increasing Hospice Nurses' Knowledge and Improving Attitudes on Pain Assessment in Dementia Patients

Nova Southeastern University, Davie, Florida, USA

Increasing Hospice Nurses’ Knowledge and Improving Attitudes on Pain Assessment in Dementia Patients, Lyn M. Peugeot, DNP, Assistant Professor, Ron and Kathy Assaf College of Nursing, Entry-Level Nursing Department Objective. The purpose of this evidence-based practice (EBP) project was to increase hospice nurses’ knowledge and improve attitudes on pain assessment in dementia patients by implementing an EBP training program on utilizing the Pain Assessment in Advanced Dementia Scale (PAINAD). Background. Dementia patients have difficulty articulating pain due to cognitive deficits in communication, sensation, and overall physical decline from the aging and disease process. Patients with dementia are considered at-risk for uncontrolled pain due to under-assessment, or untreated pain. Current research notes gaps in pain assessment among nurses due to knowledge deficits and attitudes on pain assessment for dementia patients. Methods. A before and after project design with pre-test/post-test measurements was used to determine whether providing EBP training on utilizing the PAINAD Scale for pain assessment increased hospice nurses’ knowledge and improved attitudes on pain assessment in dementia patients. A total of 44 nurses participated in the EBP training program. Results. Comparison of pretest-posttest training measures demonstrated a statistically significant improvement in nurses’ attitudes following the completion of the training program with t = -7.69 and p = 0.00. Hospice nurses’ knowledge gains were not statistically significant with t = -1.10 and p = 0.280 overall, but when the data were evaluated based on nurse level of education, there was significance with t = -3.21 and p = .003. Conclusion. Although gains in knowledge were not attained, changes in attitude should enhance nurse ability and willingness to assess and manage pain in dementia patients.